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# Middle phalanx, middle finger

The middle phalanx of the middle finger is the longest middle finger bone; tendons that bend and straighten the middle joint attach to it.

Official name: Middle phalanx of the middle finger

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## What it is

The middle bone of the middle finger.

## What it does

One of the finger bones; the joints between them let the finger curl.

## Key points

- The longest middle phalanx; the FDS slips insert on its sides and the central slip on its dorsal base
- Pilon or dorsal fracture-dislocations of the PIP joint involve its base and are hard to keep reduced

## Key facts

**Joints with**
Proximal phalanx (PIP), distal phalanx (DIP)

**Landmarks**
Base, shaft, head; FDS inserts on its sides

## Relations

**Above**
Head of the proximal phalanx at the PIP joint

**In front**
FDP tendon between the FDS slips

**Behind**
Central slip and lateral bands of the extensor mechanism

## How to find it

Felt on the back of the middle finger between the PIP and DIP joints; a jammed PIP joint here swells into a spindle shape that hides the bone outline.

## Examination

- Elson test: with the PIP bent 90° over a table edge, the person tries to straighten the middle phalanx against resistance; weakness with a rigid, extending DIP indicates a central slip tear

## On imaging

On a true lateral view, a palmar base fragment means a volar plate avulsion; if the joint is not congruent (dorsal V-shaped gap), the fracture-dislocation is unstable. Stress views or fluoroscopy can check stability.

## Clinical notes

- Volar plate avulsion at its palmar base after a hyperextension jam is a common ball-sport injury
- Pilon fractures of its base from an axial blow are often treated with dynamic traction so the PIP joint keeps moving while it heals

## Development

Ossifies from a shaft centre before birth and a secondary centre at its base that fuses in adolescence; it is the longest middle phalanx because the middle finger is the longest digit.

## Related conditions

- [Mallet finger](https://durgical.com/en/conditions/mallet-finger/)

## Test yourself

Think of the answer, then tap the question to see it.

## Which is the longest middle phalanx?

The middle phalanx of the middle finger.

## Which tendons insert on the middle phalanx of the middle finger?

The flexor digitorum superficialis slips on its sides and the extensor central slip on its dorsal base.

## What common ball-sport injury involves the palmar base of the middle phalanx of the middle finger?

Volar plate avulsion after a hyperextension jam of the PIP joint.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
phalanx media manus TA2 1278

**Official Spanish (DeCS)**
Falange media del dedo medio

**English (TA2)**
Middle phalanx of the middle finger

## Related

- [Extensor tendons](https://durgical.com/en/anatomy/extensor-digitorum-tendons/)
- [FDP tendons](https://durgical.com/en/anatomy/flexor-digitorum-profundus-tendons/)
- [FDS tendons](https://durgical.com/en/anatomy/flexor-digitorum-superficialis-tendons/)
- [Finger joint capsules](https://durgical.com/en/anatomy/finger-joint-capsules/)
- [Finger pulleys](https://durgical.com/en/anatomy/flexor-tendon-sheaths-and-pulleys/)
- [Flexor tendon sheaths](https://durgical.com/en/anatomy/flexor-tendon-synovial-sheaths/)
- [Finger collateral ligaments](https://durgical.com/en/anatomy/collateral-ligaments-of-the-finger-joints/)
- [Palmar aponeurosis](https://durgical.com/en/anatomy/palmar-aponeurosis/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Hand Bones](https://www.ncbi.nlm.nih.gov/books/NBK547684/); [8.2 Bones of the Upper Limb](https://openstax.org/books/anatomy-and-physiology-2e/pages/8-2-bones-of-the-upper-limb) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/); [8.5 Development of the Appendicular Skeleton](https://openstax.org/books/anatomy-and-physiology-2e/pages/8-5-development-of-the-appendicular-skeleton) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/); Anatomy of the Human Body (20th ed.): Articulations of the Digits (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/middle-phalanx-of-the-middle-finger/